Select An Option

Premium $1250 Annually

Preferred $700 Annually

Primary $375 Annually

Associate $275 Annually

For non-profit organizations only.

Affiliate $200 Annually

For elected officials only.

CHT Affiliate $100 Annually

Only available to groups enrolling in Chambers Health Trust (CHT) health plan coverage and located outside of Jefferson Parish.

Enter Contact Information

Prefix (i.e. Mr. Mrs. Dr.)

First Name

Last Name

Suffix (i.e Jr. Sr. III)

Designations

E-mail

Family NameBusiness Name

Please select a valid membership option and fee item if exist